Urine qRT-PCR assay as a screening tool for the detection ofcongenital human cytomegalovirus infection of infants

Abstract

Congenital cytomegalovirus (CMV) infection is the most common infectious cause of birth defects. It may
cause both, immediate and long term health problems in infants. These include variety of symptoms, such
as hearing loss, microcephaly, jaundice, hepatosplenomegaly and seizures. In more severe cases CMV
infection can cause the death of an unborn baby and loss of pregnancy. Despite being one of the most
extensively studied vertically transmitted infections recently, the adverse effects of vertically transmitted
CMV infection are still not well presented to the general public, resulting in a low awareness among
potential expectant mothers in Bosnia and Herzegovina. This study aims to elucidate the sensitivity of urine
samples for CMV detection in infants as well as to reflect the importance of quantitative real-time PCR
(qRT-PCR) in diagnostics of CMV infection in infants. qRT-PCR was used in this study as a technique for
the screening of CMV DNA in a cohort of patients based in Sarajevo Canton. These results have shown
that urine samples are sufficiently sensitive for the detection of CMV DNA in infants. Furthermore, the
simultaneous analysis of several patients has shown a higher number of CMV DNA copies amplified in
urine compared to blood samples, derived from the same patient, thus proposing urine as a reliable sample
of choice for congenital CMV diagnostics. These findings may propose a need to classify qRT-PCR CMV
test among one of the recommended first-trimester pregnancy screening tests, which could help in early
detection of CMV infection in Sarajevo Canton.